<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Store_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-store_id" data-rule="required" data-source="fzdc/store/store/index" data-field="title"
                   class="form-control selectpage" name="row[store_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Title')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-title" data-rule="required" class="form-control" name="row[title]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Id_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-id_number" data-rule="required" class="form-control" name="row[id_number]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" data-rule="required" class="form-control" name="row[mobile]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Store_image')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-store_image" class="form-control" size="50" name="row[store_image]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-store_image" class="btn btn-danger faupload"
                                  data-input-id="c-store_image"
                                  data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp"
                                  data-multiple="false" data-preview-id="p-store_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-store_image" class="btn btn-primary fachoose"
                                  data-input-id="c-store_image" data-mimetype="image/*" data-multiple="false"><i
                            class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-store_image"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-store_image"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Yy_image')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-yy_image" class="form-control" size="50" name="row[yy_image]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-yy_image" class="btn btn-danger faupload"
                                  data-input-id="c-yy_image"
                                  data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp"
                                  data-multiple="false" data-preview-id="p-yy_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-yy_image" class="btn btn-primary fachoose"
                                  data-input-id="c-yy_image" data-mimetype="image/*" data-multiple="false"><i
                            class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-yy_image"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-yy_image"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Font_image')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-font_image" class="form-control" size="50" name="row[font_image]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-font_image" class="btn btn-danger faupload"
                                  data-input-id="c-font_image"
                                  data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp"
                                  data-multiple="false" data-preview-id="p-font_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-font_image" class="btn btn-primary fachoose"
                                  data-input-id="c-font_image" data-mimetype="image/*" data-multiple="false"><i
                            class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-font_image"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-font_image"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Back_image')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-back_image" class="form-control" size="50" name="row[back_image]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-back_image" class="btn btn-danger faupload"
                                  data-input-id="c-back_image"
                                  data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp"
                                  data-multiple="false" data-preview-id="p-back_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-back_image" class="btn btn-primary fachoose"
                                  data-input-id="c-back_image" data-mimetype="image/*" data-multiple="false"><i
                            class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-back_image"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-back_image"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Hard_image')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-hard_image" class="form-control" size="50" name="row[hard_image]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-hard_image" class="btn btn-danger faupload"
                                  data-input-id="c-hard_image"
                                  data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp"
                                  data-multiple="false" data-preview-id="p-hard_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-hard_image" class="btn btn-primary fachoose"
                                  data-input-id="c-hard_image" data-mimetype="image/*" data-multiple="false"><i
                            class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-hard_image"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-hard_image"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Self_image')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-self_image" class="form-control" size="50" name="row[self_image]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-self_image" class="btn btn-danger faupload"
                                  data-input-id="c-self_image"
                                  data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp"
                                  data-multiple="false" data-preview-id="p-self_image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-self_image" class="btn btn-primary fachoose"
                                  data-input-id="c-self_image" data-mimetype="image/*" data-multiple="false"><i
                            class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-self_image"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-self_image"></ul>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
